Table of Contents : Vol. 1, No. 5 (2018)

Philippine Journal of Medicine, Issue 5, 2018
The Philippine Journal of Medicine (PJM), released its first issue in 2014 and has become an annual and general medical journal under the College of Medicine, Our Lady of Fatima University. This 2017, PJM marks an incremental step for the journal as it took re-branding efforts and transcends the borders for wider reach of Philippine health research. The PJM, now as a national journal, approaches medicine in the lens of public health with the focus to stimulate discussion and elicit debate on the current prominent health issues and consequently, aims to influence the Philippine health agendas, priorities, and policies. As an open-access and peer-reviewed journal, PJM features original research, reviews, commentary and special issues complemented by regular blog posts that entail the journal's core principle of health research-priority-setting. The journal is now hosted by the Research Development and Innovation Center of the Our Lady of Fatima University.


Made Hendra Satria Nugraha, Ni Wayan Tianing, Ari Wibawa, Putu Ayu Sita Saraswati, Putu Gede Surya Adhitya
Physiotherapy Department, Faculty of Medicine, Udayana University
Knee osteoarthritis is a chronic degenerative joint disease that causes damage of the articular cartilage and reduction of functional ability. Osteoarthritis usually occurs in older people which is estimated around 60%-70% cases at the age of 60 years. Osteoarthritis is a major cause of disability among elderly group. The purpose of this research was to verify the differences of microwave diathermy treatment and isometric quadriceps muscle exercise compared with microwave diathermy treatment and perturbation training in improving functional ability of people with knee osteoarthritis. This research was an experimental study with pre and post-test control group design. The sample consists of 24 people who were divided into two groups. Group 1 was received microwave diathermy treatment and isometric quadriceps muscle exercise, while Group 2 was received microwave diathermy treatment and perturbation training. WOMAC Index was used to measure the functional ability. The hypothesis was tested using paired sample t-test in Group 1 showed p=0.000 with a mean difference 18.167±1.528, while in Group 2 showed p=0.000 and mean difference 21.250±1.712. These results represent a significant improvement in functional ability in each group. Comparison was tested using independent sample t-test and the difference was obtained with p=0.000 (p<0.005). Based on these analytics, the conclusion is the microwave diathermy treatment and perturbation training is significantly more effective compared with microwave diathermy treatment and isometric quadriceps muscle exercise to improve functional ability in individual with knee osteoarthritis.

Maria Susila Sumartiningsih
Faculty of Nursing, Pelita Harapan University
The background of the research is a phenomenon development rapidly to information and communication technology so that it implies the thrust for lecturers to improve the quality of learning through the innovative learning method of the Internet-based model in this period. The method mentioned is Flipped Classroom Learning. The purpose of this research is to analyze the differences of student perception between the influence of flipped classroom learning design towards the critical thinking and learning dependence ability of the mental health in nursing course in the nursing study program. The research method is quantitative descriptive with comparative design. Data collection through questionnaires in Likert scale design, taken from total sampling for the students who took the Mental Healing Nursing course at the Nursing Study Program in Banten Province. The results were analyzed by using Wilcoxon Signed Rank Test, found a significant difference in student perception between design flipped Classroom Learning to the critical thinking and student learning independence ability with p-value 0.0001. It was concluded that there was a significantly different perception of students between design flipped Classroom Learning on the critical thinking and student learning independence ability on mental health in nursing course at nursing undergraduate program at institution X. It was recommended to the lecturer to develop the learning method of Flipped Classroom Learning in the nursing course at the nursing undergraduate program.

Renata Komalasari, Evanny Indah Manurung
Academic Staff, Faculty of Nursing, University of Pelita Harapan
Higher life expectancy contributes to increased number of older people. Various body functions decline as one ages, affecting quality of life of older people. Quality of life is the perception of the individuals in the context of the culture and value systems in which they live. The purpose of this study was to compare quality of life of older people between patients in outpatient department and community. This was a quantitative descriptive study involving 199 elder people. Sampling was collected using purposive sampling with inclusion criteria: 60 years old or over, able to communicate and understand Indonesian language, willingness to become respondents, and not having hearing or visual loss that hinders participation. Quality of life was measured by the World Health Organisation Quality of Life-BREF questionnaire (WHOQOL-BREF) which consisted of four domains (physical health, psychological aspect, social relationships, and environment). Ethical approval for this study was received from the Mochtar Riady Research Institute and Nanotechnology. Data were analyzed with descriptive analysis. The number of respondents in both settings were comparable (99 vs 100 respondents). In each domain in both settings, there were more respondents were in good/satisfactory/active/adequate category than in bad/unstable/inactive/inadequate category. Nearly half of the respondents in the community (48.4%) and in the outpatient department (50%) were unstable psychologically. Further research is warranted on the association of quality of life of older people between both settings.

Dr. Zharlah Gulmatico Flores, Dr. Remedios P. Santos
Department of Biochemistry and Applied Nutrition, College of Medicine, Our Lady of Fatima University
Koordersiodendron pinnatum, an endemic deciduous tree to the Southeast Asia, is known for its construction and furniture purposes. The potential of K. pinnatum as an antibacterial and antioxidant agent has been explored already, but other than those is still unknown. This study aims to assess K. pinnatum as a possible cytotoxic agent against MCF7 human breast cancer, HCT116 human colorectal cancer, and A549 human lung cancer cell lines. The phytochemical study reveals that K. pinnatum crude extract contains tannins, saponins, cardiac glycosides, phenolic compounds, and steroids. Using MTT assay, absorbance readings of four concentrations in triplicates were analyzed in STATA version 12 using ANOVA of multiple measures, and Bonferroni's test as post hoc analysis, revealing significant differences in all treatment at p<0.001. IC50 values are obtained using the software ‘icpin’ which uses linear interpolation. IC50 values obtained are 19.54 for HCT116, 24.31 for MCF7 and 26.03 for A549. Using unpaired t-test, the differences between the IC50 of the extract and the positive control drugs reveals p=0.0198, p=0.0028, p=0.0234 for K. pinnatum against Tamoxifen, 5-fluorouracil and Cisplatin, respectively. The lower the IC50 value is, the more potent cytotoxic agent the extract is. According to the American National Cancer Institute, extract with IC50 value that is less than 30 μg/ml, is considered to have an anticancer property. The results indicate K. pinnatum ethanolic crude extract exerts cytotoxic property by inhibiting the proliferation of the three cell lines with HCT116 as the most inhibited, followed by MCF7, and lastly, the A549. The differences in IC50 values of the three cell lines indicate the differences in the morphological characteristics of each cell line and the different apoptotic pathway being targeted.

Indah Mei Rahajeng
Faculty of Medicine, Udayana University
One of the obstacles faced in achieving sustainable development is inequality of health services. The concern about health service inequality is not only focused on the disproportion numbers of health professionals but also specifically an uneven number of health specialists in rural and urban areas. Several studies indicate that telehealth could ease the problem of inequality health service. Thus, telehealth is one of the advanced attempts in achieving sustainable development. This study aimed to describe how telehealth is applied to manage emergency cases specifically in rural and remote regions. A systematic review of eighteen articles was carried out, and articles were retrieved from MEDLINE, CINAHL, PsycINFO, EMBASE and Global Health databases. The articles were critically reviewed and analyzed to answer this study’s aim. The critical review of the articles were categorized in themes: 1) application of telehealth in rural emergency care, 2) implication of tele-emergency care, 3) potential challenges and facilitators for tele-emergency implementation, 4) nursing implication on tele-emergency. Telehealth is feasible to apply in rural emergency care; furthermore, assessment and clinical decision-making using telehealth is indicated as reliable. Telehealth application in remote emergency care is also indicated as time and cost effective. Several implications of telehealth on rural emergency care have also been recognized, such as the implication on the clinical decision-making process and patient safety during emergency case management. The potential challenges of tele-emergency are internet connectivity, lack of ability of users in operating telehealth technology, and trust issue. Telehealth facilitates rural nurses to consult in remote specialists during emergency case management. Although several challenges might be potentially affected its application, telehealth is a feasible and reliable system for rural emergency health service. Furthermore, telehealth is also considered as a simple, effective and efficient system, which is both cost and time effective.

Irvin L. Ong, Michael Joseph S. Diño, Maria Minerva P. Calimag, Fe A. Hidalgo
The Graduate School, University of Santo Tomas, Research Development and Innovation Center, Our Lady of Fatima University
Continuing professional development (CPD) has been an indispensable activity in ensuring quality health care and outcomes. Although a myriad of modalities are available, CPD continues to be ambiguous due to the divergent and convergent views on its design and implementation. This study explored the preferred CPD modes using the identified attributes in the lens of health professionals as lifelong learners. A discrete choice experiment was conducted using Sawtooth Software’s application platform. Respondents (N=152) completed an online conjoint survey that had 10 choice tasks with 3 concepts and 1 “none” alternative. Conjoint analysis was performed to generate the relative importance, utility values, and latent class. Based on the country of practice and profession, group comparisons were done to determine statistical differences. CPD preference is determined by the importance of turf (31%), theme (24%), time (16%), tech (15%), and teach (14%). The highest utility values per attribute are mixed environment (M = 50.12; SD = 54.72), exploratory teaching (M = 29.74; SD = 30.64), multiprofessional learning (M = 28.18.; SD = 47.59), short duration (M = 20.65; SD = 44.37), and desktop technology (M = 4.70; SD = 47.35). The country of practice yields no significant differences on the relative importance and part-worths. However, the profession itself shows small significant effect on the theme (F = 3.70; η2 = 0.05) and produces small to moderate effects on multiprofessionalism (F = 11.92; η2 = 0.14), interprofessionalism (F = 3.40; η2 = 0.04), real (F = 7.23; η2 = 0.09), and virtual (F = 9.92; η2 = 0.12) environments. Lastly, the segmentation analysis revealed 2 latent classes of CPD preference among health professionals. This study was successful in uncovering the two main preferred CPD modes, namely: “CPD On-Board” or “CPD On-hand”, which is highly contingent on the educational technology. Those involved in the design, implementation, and evaluation of CPD should consider this classification in the curriculum development process. Designers are advised to focus on creating shorter CPD programs in a mixed learning environment that promotes multi- and inter- professional learning facilitated by exploratory teaching methods.